Resection margin influences survival after pancreatoduodenectomy for distal cholangiocarcinoma

Terence C. Chua*, Anubhav Mittal, Jenny Arena, Amy Sheen, Anthony J. Gill, Jaswinder S. Samra

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Introduction: Distal cholangiocarcinoma remains a rare cancer associated with a dismal outcome. There is a lack of effective treatment options and where disease is amendable to resection, surgery affords the best potential for long-term survival. The aim of this study was to examine the survival outcomes and prognostic factors of patients undergoing pancreatoduodenectomy for distal cholangiocarcinoma. Methods: Between January 2004 to May 2016, patients who had undergone pancreatoduodenectomy with histologically proven distal cholangiocarcinoma were identified. Clinicopathologic data and survival outcomes were reported. Results: Pancreatoduodenectomy alone was performed in 20 patients (71%) and eight patients (29%) required concomitant vascular resection. The major complication rate was 43% (n = 12). Nineteen patients (68%) had node positive disease. Eighteen patients (64%) had R0 resection. The median survival was 36 months (95%CI 9.7 to 63.8) and 5-year survival rate was 24%. Univariate analysis identified ASA (P < 0.001), tumor grade (P = 0.009) and margin status (P = 0.042) as prognostic factors associated with survival. Conclusion: Long-term survival may be achieved in selected patients undergoing pancreatoduodenectomy for distal cholangiocarcinoma, especially in patients who achieved an R0 resection.

Original languageEnglish
Pages (from-to)1072–1076
Number of pages5
JournalAmerican Journal of Surgery
Issue number6
Publication statusPublished - Jun 2017


  • Biliary tract cancer
  • Cholangiocarcinoma
  • Cisplatin
  • Pancreatoduodenectomy
  • Surgery


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